Guixiang Liao1, Yuting Qian2, Sumbal Arooj1,3, Zhihong Zhao4, Maosheng Yan1, Zihuang Li1, Hongli Yang1, Tao Zheng1, Gang Li5, Xianming Li1, Muhammad Khan1,6. 1. Department of Oncology, Shenzhen People's Hospital, The First Affiliated Hospital Of Southern University Of Science And Technology, Shenzhen, China. 2. Department of Radiation Oncology, Shenzhen People's Hospital, The Second College of Jinan University, Shenzhen, China. 3. Department of Biochemistry and Molecular Biology, University of Sialkot, Sialkot, Pakistan. 4. Department of Nephrology, Shenzhen People's Hospital, Second Clinical Medicine Centre, Jinan University, Shenzhen, China. 5. Department of Chemoradiation Oncology, The First Affiliated Hospital Of Wenzhou Medical University, Wenzhou, China. 6. Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.
Abstract
BACKGROUND: Radiation therapy (RT) is the mainstay of brain metastases (BMs), and anti-PD-1 blockade has led to intracranial responses in non-small cell lung carcinoma (NSCLC) patients with BMs. OBJECTIVE: This study aimed to evaluate the efficacy and safety of adding anti-PD-1 blockade to RT in the management of NSCLC patients with BM in terms of survival outcome. MATERIALS AND METHODS: We retrospectively reviewed 70 NSCLC patients with BMs who were treated with whole brain radiation therapy (WBRT) between January 2016 and January 2021. Of the 70 patients, 29 additionally received anti-PD-1 therapy within 30 days of WBRT initiation. Baseline characteristics of the patients and efficacy outcomes such as progression-free survival (PFS) and overall survival (OS) were statistically compared using SPSS v26. Results were obtained using the Chi-square test/Fisher exact test, t-test, Kaplan-Meier, and Cox regression survival analyses. RESULTS: The median survival for the entire cohort was 24 months (95% CI, 19.5-28.5). The median survival times for WBRT alone and WBRT plus anti-PD-1 therapy cohorts were 20 months (95% CI, 11.6-28.3) and 27 months (95% CI, 19.5-28.5), respectively (p=0.035). There was no statistical difference in PFS for the treatment cohorts (median PFS for WBRT alone: 7 months vs. 12 months for WBRT plus anti-PD-1, p=0.247). In EGFR wild-type subgroup (n=31), both PFS (p=0.037) and OS (p=0.012) were significantly improved. Only the treatment group (WBRT plus anti-PD-1) was a significant predictor of OS on univariate and multivariate analyses (p=0.040). There were no significant differences in adverse events among the treatment groups. CONCLUSIONS: NSCLC patients with BM receiving additional anti-PD-1 therapy may derive better OS than WBRT alone without any increase in adverse events. Prospective well-designed studies are warranted to validate and elucidate the additive effects of the two modalities in this group of patients.
BACKGROUND: Radiation therapy (RT) is the mainstay of brain metastases (BMs), and anti-PD-1 blockade has led to intracranial responses in non-small cell lung carcinoma (NSCLC) patients with BMs. OBJECTIVE: This study aimed to evaluate the efficacy and safety of adding anti-PD-1 blockade to RT in the management of NSCLC patients with BM in terms of survival outcome. MATERIALS AND METHODS: We retrospectively reviewed 70 NSCLC patients with BMs who were treated with whole brain radiation therapy (WBRT) between January 2016 and January 2021. Of the 70 patients, 29 additionally received anti-PD-1 therapy within 30 days of WBRT initiation. Baseline characteristics of the patients and efficacy outcomes such as progression-free survival (PFS) and overall survival (OS) were statistically compared using SPSS v26. Results were obtained using the Chi-square test/Fisher exact test, t-test, Kaplan-Meier, and Cox regression survival analyses. RESULTS: The median survival for the entire cohort was 24 months (95% CI, 19.5-28.5). The median survival times for WBRT alone and WBRT plus anti-PD-1 therapy cohorts were 20 months (95% CI, 11.6-28.3) and 27 months (95% CI, 19.5-28.5), respectively (p=0.035). There was no statistical difference in PFS for the treatment cohorts (median PFS for WBRT alone: 7 months vs. 12 months for WBRT plus anti-PD-1, p=0.247). In EGFR wild-type subgroup (n=31), both PFS (p=0.037) and OS (p=0.012) were significantly improved. Only the treatment group (WBRT plus anti-PD-1) was a significant predictor of OS on univariate and multivariate analyses (p=0.040). There were no significant differences in adverse events among the treatment groups. CONCLUSIONS: NSCLC patients with BM receiving additional anti-PD-1 therapy may derive better OS than WBRT alone without any increase in adverse events. Prospective well-designed studies are warranted to validate and elucidate the additive effects of the two modalities in this group of patients.
Authors: Narek Shaverdian; Aaron E Lisberg; Krikor Bornazyan; Darlene Veruttipong; Jonathan W Goldman; Silvia C Formenti; Edward B Garon; Percy Lee Journal: Lancet Oncol Date: 2017-05-24 Impact factor: 41.316
Authors: Liufu Deng; Hua Liang; Byron Burnette; Michael Beckett; Thomas Darga; Ralph R Weichselbaum; Yang-Xin Fu Journal: J Clin Invest Date: 2014-01-02 Impact factor: 14.808
Authors: Kamran A Ahmed; Sungjune Kim; John Arrington; Arash O Naghavi; Thomas J Dilling; Ben C Creelan; Scott J Antonia; Jimmy J Caudell; Louis B Harrison; Solmaz Sahebjam; Jhanelle E Gray; Arnold B Etame; Peter A Johnstone; Michael Yu; Bradford A Perez Journal: J Neurooncol Date: 2017-05-02 Impact factor: 4.130
Authors: Vanda Téglási; Lilla Reiniger; Katalin Fábián; Orsolya Pipek; Irén Csala; Attila G Bagó; Péter Várallyai; Laura Vízkeleti; Lívia Rojkó; József Tímár; Balázs Döme; Zoltán Szállási; Charles Swanton; Judit Moldvay Journal: Neuro Oncol Date: 2017-08-01 Impact factor: 12.300
Authors: Simon J Dovedi; Amy L Adlard; Grazyna Lipowska-Bhalla; Conor McKenna; Sherrie Jones; Eleanor J Cheadle; Ian J Stratford; Edmund Poon; Michelle Morrow; Ross Stewart; Hazel Jones; Robert W Wilkinson; Jamie Honeychurch; Tim M Illidge Journal: Cancer Res Date: 2014-10-01 Impact factor: 12.701